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Case Reports
. 2020 Sep 16;21(1):236.
doi: 10.1186/s12931-020-01504-y.

Pneumothorax in COVID-19 disease- incidence and clinical characteristics

Massa Zantah  1 , Eduardo Dominguez Castillo  2 , Ryan Townsend  2 , Fusun Dikengil  2 , Gerard J Criner  2
Affiliations
Case Reports

Pneumothorax in COVID-19 disease- incidence and clinical characteristics

Massa Zantah et al. Respir Res. .

Abstract

Background: Spontaneous pneumothorax is an uncommon complication of COVID-19 viral pneumonia. The exact incidence and risk factors are still unknown. Herein we review the incidence and outcomes of pneumothorax in over 3000 patients admitted to our institution for suspected COVID-19 pneumonia.

Methods: We performed a retrospective review of COVID-19 cases admitted to our hospital. Patients who were diagnosed with a spontaneous pneumothorax were identified to calculate the incidence of this event. Their clinical characteristics were thoroughly documented. Data regarding their clinical outcomes were gathered. Each case was presented as a brief synopsis.

Results: Three thousand three hundred sixty-eight patients were admitted to our institution between March 1st, 2020 and June 8th, 2020 for suspected COVID 19 pneumonia, 902 patients were nasopharyngeal swab positive. Six cases of COVID-19 patients who developed spontaneous pneumothorax were identified (0.66%). Their baseline imaging showed diffuse bilateral ground-glass opacities and consolidations, mostly in the posterior and peripheral lung regions. 4/6 cases were associated with mechanical ventilation. All patients required placement of a chest tube. In all cases, mortality (66.6%) was not directly related to the pneumothorax.

Conclusion: Spontaneous pneumothorax is a rare complication of COVID-19 viral pneumonia and may occur in the absence of mechanical ventilation. Clinicians should be vigilant about the diagnosis and treatment of this complication.

Keywords: COVID-19; Pneumothorax; Spontaneous pneumothorax.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Baseline CT scan of the chest. Areas of GGOs, consolidations and crazy paving seen commonly bilaterally, more predominant in the posterior and peripheral lung regions. From top left: a Case-1. b Case −2. c Case −3. d Case-4. e Case-5. f Case 6
Fig. 2
Fig. 2
Interim chest radiographs for each patient prior to developing pneumothorax. From top left: a Case-1. b Case − 2. c Case − 3. d Case-4. e Case-5. f Case 6
Fig. 3
Fig. 3
Chest radiograph for each patient revealing the pneumothorax. From top left: a Case-1 Large, left. b Case − 2 after pneumothoraces developed and chest tubes were placed. Residual right sided subcutaneous emphysema. c Case − 3. Moderate, right. d Case-4. Small, left apical e Case-5. Small, bilateral f Case- 6. Large, right
See this image and copyright information in PMC

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